Aaron J. Krych<\/b><\/strong><\/p>\n<\/div>\n Knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score served as the primary outcome, with secondary outcomes including incidence of radiographic and symptomatic knee OA, isokinetic knee muscle strength, and patient-reported pain and knee function.<\/p>\n
Results showed an adjusted mean difference in change in the OARSI sum score of 0.39, with participants in the arthroscopic partial meniscectomy group experiencing more progression. Berg and colleagues found the arthroscopic meniscectomy group had an incidence of radiographic knee OA of 23% vs. 20% in the exercise group. Isokinetic knee muscle strength and patient-reported outcomes had no clinically relevant differences between the two groups, according to results.<\/p>\n
\u201cHistorically, we grouped these all as \u2018atraumatic\u2019 meniscus tears and now we\u2019re getting a little bit more nuanced into subclassifying these. How do we know there\u2019s not a radial tear or a root tear in the group that was scoped here that brought the scores down?\u201d Krych said in his presentation. \u201cI\u2019d say, overall, if you don\u2019t have displacement of fragments, it\u2019s clear that physical therapy is very much supportive of nonoperative management, but you have to look for those outliers.\u201d<\/p>\n
KOOS pain<\/h2>\n The second paper, published by the MOON Knee Group in the American Journal of Sports Medicine<\/i>, used data from 2,387 patients who underwent unilateral primary ACL reconstruction from 2002 to 2008 without a history of medial or lateral meniscal surgery and contralateral ACL reconstruction to determine whether medial meniscal repair decreased KOOS pain in 10 years after ACL reconstruction as well as assess the consequences of subsequent surgery on the development of KOOS pain.<\/p>\n
At 10-year follow-up, 252 patients reported KOOS pain of less than 80 and 1,573 reported KOOS pain of 80 or greater. The MOON Knee Group found patients who underwent a medial meniscal procedure had a significant likelihood of subsequent surgery. Results also showed subsequent surgery significantly increased the likelihood of KOOS pain of less than 80.<\/p>\n
When patients had a successful medial meniscal repair without subsequent surgery, researchers found the likelihood of KOOS pain of less than 80 decreased by 7.1%, while the likelihood of KOOS pain of less than 80 increased by 2.9% when subsequent surgery was performed after medial meniscal repair and ACL reconstruction.<\/p>\n
\u201cWhat I take away from this is repair the meniscus, if at all possible, during an ACL because long term that will do better if it heals,\u201d Krych said. \u201cBut I think we need to do a better job of repairing the posterior horn to the medial meniscus. It starts with diagnosis, really scrutinizing your MRI, being able to see that tear and doing that posterior drawer. This is why I\u2019m a little bit more conservative with bracing and partial weight-bearing.\u201d<\/p>\n
Meniscal bucket handle tear<\/h2>\n Finally, in a retrospective review of data from patients aged 18 years or older with a meniscal bucket handle tear after ACL reconstruction, Alexander J. Hoffer, MD, and colleagues found the presence of a ramp tear on preoperative MRI before the index ACL surgery was the only independent factor that predicted the occurrence of medial meniscus bucket handle tear vs. lateral meniscus bucket handle tear.<\/p>\n
\u201cAlmost three in four patients had a posterior medial bone bruise pattern and possible ramp at the time of ACL injury,\u201d Krych said. \u201cTheir take home was that these unrepaired ramp lesions are a risk factor for subsequent bucket handle tears. The takeaway is you have to look at your MRI and study it carefully, but don\u2019t miss it at the time of arthroscopy.\u201d<\/p>\n
For more information:<\/h2>\n Aaron J. Krych, MD,<\/b> can be contacted at krych.aaron@mayo.edu.<\/p>\n\n
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Published by:<\/span>\n
Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Krych AJ. Meniscus. Presented at: Orthopedics Today Hawaii; Jan. 11-15, 2026; Waikoloa, Hawaii.<\/p>\n
References:<\/h2>\n\n
Disclosures: <\/strong>
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